Recent discussions among officials at the Centers for Disease Control and Prevention (CDC) indicate that organizations receiving overdose-prevention funding may soon be prohibited from promoting the crucial message to “never use alone.” This revelation came from a meeting this month, details of which were obtained by News.

The meeting aimed to align recipients of Overdose Data to Action (OD2A) funding with the directives outlined in the executive orders from the previous administration. Notably, the July order titled “Ending Crime and Disorder on America’s Streets” plays a pivotal role in shaping these new guidelines.

This executive order specifically prohibits federally funded “harm reduction” and “safe consumption” initiatives, asserting that these efforts “only facilitate illegal drug use and its attendant harm.” Harm reduction encompasses various strategies aimed at minimizing the risks associated with drug use, traditionally including interventions such as condom distribution, clean syringes, and overdose-reversal medications like Narcan.

Leo Beletsky, a law and health sciences professor at Northeastern University, explained that the philosophy guiding this shift is known as “moral hazard.” He noted, “The idea is that by making a risky activity less risky, you’re encouraging people to engage in it.” Beletsky emphasized that if the fear of imprisonment does not deter drug use, neither will the availability of clean syringes.

During the meeting, state and municipal health department officials sought clarification on whether they could continue to promote the “never use alone” message. They were met with vague responses, leaving many questions unanswered.

A spokesperson from the Department of Health and Human Services, which oversees the CDC, reaffirmed their commitment to implementing the President’s Executive Orders across the Department.

Dr. Jennifer Hua, medical director for public health in Chicago, which has seen notable decreases in overdose fatalities, argued that messaging like “carry Narcan” and “never use alone” is foundational to effective harm reduction strategies.

While the executive order disparages harm reduction overall, CDC officials indicated that Narcan and fentanyl test strips would still be permitted, resulting in confusion about the government’s stance on harm reduction strategies.

Hua pointed out the inconsistency, noting that in some states, test strips are still categorized as illegal paraphernalia. Beletsky added that this indecisiveness over the definition of harm reduction is “absurd,” particularly as the administration permits certain interventions traditionally viewed as harm reduction while simultaneously undermining the concept.

Organizations focused on harm reduction have promoted take-home Narcan for decades and have played crucial roles in distributing fentanyl test strips to warn users about contaminants. Hua emphasized the importance of combining Narcan distribution with the “never use alone” message, explaining that individuals at risk of overdose need someone present to administer Narcan effectively.

Despite being anecdotal, Hua highlighted a significant decline in overdose fatalities across four out of five neighborhoods in western Chicago most affected by the crisis. These neighborhoods, where drug use occurs predominantly outdoors, enable bystanders to assist in emergencies, contrasting with Austin, where indoor usage persisted without a similar decline.

Beletsky stated that isolation significantly contributes to overdose fatalities. “Connection is key to the recovery process,” he asserted, defining the “never use alone” message as one of hope, connection, and essential support critical for addressing the overdose crisis.

He expressed concern that potential policy shifts might reverse progress made in overdose prevention, warning that “we may return to trends spiraling out of control.”

Andrew Kolodny, a medical director at the Opioid Policy Research Collaborative, critiqued the focus on executive order language, emphasizing that the real issue lies in inadequate funding for overdose and addiction prevention efforts. He noted that funding is often limited to two-year increments, complicating the development of a comprehensive treatment system. Kolodny recalled President Biden’s 2020 commitment to enhance the nation’s treatment capacity, which has not materialized as expected.

“Under the previous administration, we are even less likely to see new funding streams,” Kolodny added, conveying that there are more pressing concerns than the nuances of executive order language.